tbuckley/cabot-search huggingface dataset:
Utilization, surgical populations, centers, coverages, regional balance, and their influential factors of deep brain stimulation for Parkinson’s disease: a large-scale multicenter cross-sectional study from 1997 to 2021
Authors: Fangang Meng, Wei Hu, Shu Wang, Joseph Tam, Yuan Gao, Xian Lun Zhu, Danny Tat Ming Chan, Wai Sang Poon, Tak Lap Poon, Fung Ching Cheung, Benedict Beng Teck Taw, Lai Fung Li, Shin Yuan Chen, Ka Ming Chan, Anxin Wang, Qin Xu, Chunlei Han, Yutong Bai, Aparna Wagle Shukla, Adolfo Ramirez-Zamora, Andres M Lozano, Jianguo Zhang
Journal: International Journal of Surgery (2023)

Deep brain stimulation (DBS) is an emerging and effective therapy for Parkinson's disease (PD). However, little is known about its utilization, surgical populations, centers, coverages, regional balance, and influential factors. This large-scale multicenter cross-sectional study was conducted using a national census involving 74 Chinese centers. National DBS populations and centers for PD were investigated in 1997-2021, and regional sociodemographic features, surgical populations, related resources, and insurance policies in 2020 were explored. Since the first DBS surgery in 1997, a total of 38 122 PD patients from 349 centers underwent DBS by 2021, which covered 1.118% (1.108-1.129) of patients and 0.954% (0.933-0.976) of centers. Significant upward trends in the annual surgical population and coverages were observed with rapid climbing rates, while the annual surgical centers and their coverage showed two growth peaks in 2002-2006 and 2010-2018, correlating with clinical approvals and new technologies. A total of 103 070 (51 165-154 975) PD patients [2.088% (1.351-2.825) coverage] and 603 (72-1134) centers [1.356% (1.126-1.586) coverage] are predicted to conduct DBS by 2030. The new remotely programmed DBS technology was recoded as the first application in 2015 and rapidly increased to 2771 (47.39%, 46.11-48.67) patients with 10 507 remote programming sessions annually in 2021. Provinces in the eastern and central regions had better economic status, more surgical patients, higher insurance affordability, and more related resources than those in the western and northeastern regions. Higher gross domestic product per capita ( β =5.041, 3.324-6.758 and β =0.008, 0.004-0.012; all P <0.001) and more functional neurosurgery doctors ( β =3.596, 0.353-6.839; P =0.031 and β =0.010, 0.002-0.017; P =0.013) positively influenced surgical populations and coverages, while higher insurance levels ( β =128.888, 64.702-193.075; P <0.001) positively influenced surgical coverages. Although surgical populations, centers, and coverages of DBS for PD have rapidly improved and are predicted to show future increases, this is still insufficient to cover potential eligible patients. Regionally imbalanced health coverage should be given attention to promote coordinated development.
The gap before real clinical application of imaging-based machine-learning and radiomic models for chemoradiation outcome prediction in esophageal cancer: a systematic review and meta-analysis
Authors: Zhi Yang, Jie Gong, Jie Li, Hongfei Sun, Yanglin Pan, Lina Zhao
Journal: International Journal of Surgery (2023)

Due to tumoral heterogeneity and the lack of robust biomarkers, the prediction of chemoradiotherapy response and prognosis in patients with esophageal cancer (EC) is challenging. The goal of this study was to assess the study quality and clinical value of machine learning and radiomic-based quantitative imaging studies for predicting the outcomes of EC patients after chemoradiotherapy.PubMed, Embase, and Cochrane were searched for eligible articles. The methodological quality and risk of bias were evaluated using the Radiomics Quality Score (RQS), Image Biomarkers Standardization Initiative (IBSI) Guideline, and Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) statement, as well as the modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. A meta-analysis of the evidence focusing on predicting chemoradiotherapy response and outcome in EC patients was implemented.Forty-six studies were eligible for qualitative synthesis. The mean RQS score was 9.07, with an adherence rate of 42.52%. The adherence rates of the TRIPOD and IBSI were 61.70 and 43.17%, respectively. Ultimately, 24 studies were included in the meta-analysis, of which 16 studies had a pooled sensitivity, specificity, and area under the curve (AUC) of 0.83 (0.76-0.89), 0.83 (0.79-0.86), and 0.84 (0.81-0.87) in neoadjuvant chemoradiotherapy datasets, as well as 0.84 (0.75-0.93), 0.89 (0.83-0.93), and 0.93 (0.90-0.95) in definitive chemoradiotherapy datasets, respectively. Moreover, radiomics could distinguish patients from the low-risk and high-risk groups with different disease-free survival (DFS) (pooled hazard ratio: 3.43, 95% CI 2.39-4.92) and overall survival (pooled hazard ratio: 2.49, 95% CI 1.91-3.25). The results of subgroup and regression analyses showed that some of the heterogeneity was explained by the combination with clinical factors, sample size, and usage of the deep learning (DL) signature.Noninvasive radiomics offers promising potential for optimizing treatment decision-making in EC patients. However, it is necessary to make scientific advancements in EC radiomics regarding reproducibility, clinical usefulness analysis, and open science categories. Improved model reporting of study objectives, blind assessment, and image processing steps are required to help promote real clinical applications of radiomics in EC research.
A commentary on ‘Effectiveness of artificial intelligence-assisted colonoscopy in early diagnosis of colorectal cancer: a systematic review’
Authors: Si-Un Frank Chiu, Kuo-Chuan Hung, Chong-Chi Chiu
Journal: International Journal of Surgery (2023)

aDepartment of Computer Science, Brown University, Providence, Rhode Island, USA bDepartment of Economics, Brown University, Providence, Rhode Island, USA cDepartment of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan dDepartment of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan eDepartment of General Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan fSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan gDepartment of Medical Education and Research, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: No.21, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung, 824, Taiwan, Tel: 886-76150022, Fax: 886-76150940. E-mail address: [email protected] (C-C. Chiu). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Blood-derived lysophospholipid sustains hepatic phospholipids and fat storage necessary for hepatoprotection in overnutrition
Authors: Cheen Fei Chin, Dwight L.A. Galam, Liang Gao, Bryan C. Tan, Bernice H. Wong, Geok-Lin Chua, Randy Y.J. Loke, Yen Ching Lim, Markus R. Wenk, Miao-Shan Lim, Wei-Qiang Leow, George B.B. Goh, Federico Torta, David L. Silver
Journal: Journal of Clinical Investigation (2023)

The liver has a high demand for phosphatidylcholine (PC), particularly in overnutrition, where reduced phospholipid levels have been implicated in the development of nonalcoholic fatty liver disease (NAFLD). Whether other pathways exist in addition to de novo PC synthesis that contribute to hepatic PC pools remains unknown. Here, we identified the lysophosphatidylcholine (LPC) transporter major facilitator superfamily domain containing 2A (Mfsd2a) as critical for maintaining hepatic phospholipid pools. Hepatic Mfsd2a expression was induced in patients having NAFLD and in mice in response to dietary fat via glucocorticoid receptor action. Mfsd2a liver-specific deficiency in mice (L2aKO) led to a robust nonalcoholic steatohepatitis-like (NASH-like) phenotype within just 2 weeks of dietary fat challenge associated with reduced hepatic phospholipids containing linoleic acid. Reducing dietary choline intake in L2aKO mice exacerbated liver pathology and deficiency of liver phospholipids containing polyunsaturated fatty acids (PUFAs). Treating hepatocytes with LPCs containing oleate and linoleate, two abundant blood-derived LPCs, specifically induced lipid droplet biogenesis and contributed to phospholipid pools, while LPC containing the omega-3 fatty acid docosahexaenoic acid (DHA) promoted lipid droplet formation and suppressed lipogenesis. This study revealed that PUFA-containing LPCs drive hepatic lipid droplet formation, suppress lipogenesis, and sustain hepatic phospholipid pools - processes that are critical for protecting the liver from excess dietary fat.
Minimally invasive surgery versus laparotomy of nonmetastatic pT4a colorectal cancer: a propensity score analysis
Authors: Hui-Long Guo, Jing-Yao Chen, You-Zhen Tang, Qian-Lin Zeng, Qing-Long Jian, Ming-Zhe Li, Yu-Long He, Wen-Hui Wu
Journal: International Journal of Surgery (2023)

The aim was to compare short-term and long-term oncological outcomes between minimally invasive surgery (MIS group) and laparotomy (lap group) in nonmetastatic pT4a colorectal cancer (CRC). The study retrospectively analyzed the outcomes of 634 patients treated with radical operation from January 2015 to December 2021 for nonmetastatic pT4a CRC, with propensity score matching. The conversion rate from the MIS group to laparotomy is 3.5%. Intraoperative blood loss, time to first anal exhaust, defecation and drainage tube removal, and complication rate were significantly less in the MIS group. After 5 years, the outcomes of the MIS group were no inferior to laparotomy outcomes [overall survival (OS): 72.7 vs. 77.8%, P =0.285; disease-free survival (DFS): 72.2 vs. 75.0%, P =0.599]. And multivariate analysis showed that age greater than or equal to 60 years old, lymph node metastasis and the carcinoembryonic antigen levels were independent variables for OS, while lymph node metastasis and CA125 levels were independent variables for DFS. The results of the graph show the relationship between the sum of scores of sex, age, complications, BMI, carcinoembryonic antigen, age, CA125, tumor site, N stage and tumor length diameter and 1-year, 3-year, and 5-year mortality and DFS of patients. Among them, tumor length diameter and N stage are significantly correlated with long-term survival and disease-free of patients. MIS is safe and feasible for nonmetastatic pT4a CRC, with the added benefit of accelerated postoperative recovery. In oncology, MIS did not affect OS and DFS.
Correction, uncertainty, and anchoring effects
Authors: Chang-Yuan Lee, Carey K Morewedge
Journal: Behavioral and Brain Sciences (2023)

Abstract We compare the predictions of two important proposals made by De Neys to findings in the anchoring effect literature. Evidence for an anchoring-and-adjustment heuristic supports his proposal that system 1 and system 2 are non-exclusive. The relationship between psychophysical noise and anchoring effects, however, challenges his proposal that epistemic uncertainty determines the involvement of system 2 corrective processes in judgment.
Switching between system 1 and system 2: The nature of competing intuitions and the role of disfluency
Authors: Maryna Kołeczek, Maciej Sekerdej
Journal: Behavioral and Brain Sciences (2023)

Abstract This commentary identifies two problems concerning the switch mechanism: The model explains too few instances of switching, and the switching mechanism itself seems fallible. The improvements we suggest are to clarify the nature of the competing intuitions as the initial intuition and its negation or alternative ways to solve the problem, and to incorporate cognitive disfluency into the switching mechanism.
Screening for Lipid Disorders in Children and Adolescents
Authors: Janelle M. Guirguis-Blake, Corinne V. Evans, Erin L. Coppola, Nadia Redmond, Leslie A. Perdue
Journal: JAMA (2023)

Importance Lipid screening in childhood and adolescence can lead to early dyslipidemia diagnosis. The long-term benefits of lipid screening and subsequent treatment in this population are uncertain. Objective To review benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Data Sources MEDLINE and the Cochrane Central Register of Controlled Trials through May 16, 2022; literature surveillance through March 24, 2023. Study Selection English-language randomized clinical trials (RCTs) of lipid screening; recent, large US cohort studies reporting diagnostic yield or screen positivity; and RCTs of lipid-lowering interventions. Data Extraction and Synthesis Single extraction, verified by a second reviewer. Quantitative synthesis using random-effects meta-analysis. Main Outcomes and Measures Health outcomes, diagnostic yield, intermediate outcomes, behavioral outcomes, and harms. Results Forty-three studies were included (n = 491 516). No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395 465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142 257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level (≥200 mg/dL) was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1230) demonstrated that statins were associated with an 81- to 82-mg/dL greater mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies suggest that statin treatment for FH starting in childhood or adolescence reduces long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) demonstrated 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not persist at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups. Conclusions and Relevance No direct evidence on the benefits or harms of pediatric lipid screening was identified. While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.
Unifying theories of reasoning and decision making
Authors: Brett K Hayes, Rachel G Stephens, John C Dunn
Journal: Behavioral and Brain Sciences (2023)

De Neys offers a welcome departure from the dual-process accounts that have dominated theorizing about reasoning. However, we see little justification for retaining the distinction between intuition and deliberation. Instead, reasoning can be treated as a case of multiple-cue decision making. Reasoning phenomena can then be explained by decision-making models that supply the processing details missing from De Neys's framework.
Hoist by its own petard: The ironic and fatal flaws of dual-process theory
Authors: David E Melnikoff, John A Bargh
Journal: Behavioral and Brain Sciences (2023)

Abstract By stipulating the existence of a system 1 and a system 2, dual-process theories raise questions about how these systems function. De Neys identifies several such questions for which no plausible answers have ever been offered. What makes the nature of systems 1 and 2 so difficult to ascertain? The answer is simple: The systems do not exist.
State Public Insurance Coverage Policies and Postpartum Care Among Immigrants
Authors: Maria W. Steenland, Rachel E. Fabi, Meghan Bellerose, Arielle Desir, Maggie S. White, Laura R. Wherry
Journal: JAMA (2023)

Professional medical organizations recommend that adults receive routine postpartum care. Yet, some states restrict public insurance coverage for undocumented immigrants and recently documented immigrants (those who received legal documentation status within the past 5 years). To examine the association between public insurance coverage and postpartum care among low-income immigrants and the difference in receipt of postpartum care among immigrants relative to nonimmigrants. A pooled, cross-sectional analysis was conducted using data from the Pregnancy Risk Assessment Monitoring System for 19 states and New York City including low-income adults with a live birth between 2012 and 2019. Giving birth in a state that offered public insurance coverage for postpartum care to recently documented or undocumented immigrants. Self-reported receipt of postpartum care by the category of coverage offered (full coverage: states that offered publicly funded postpartum care regardless of immigration status; moderate coverage: states that offered publicly funded postpartum care to lawfully residing immigrants without a 5-year waiting period, but did not offer postpartum care to undocumented immigrants; no coverage: states that did not offer publicly funded postpartum care to lawfully present immigrants before 5 years of legal residence or to undocumented immigrants). The study included 72 981 low-income adults (20 971 immigrants [29%] and 52 010 nonimmigrants [71%]). Of the 19 included states and New York City, 6 offered full coverage, 9 offered moderate coverage, and 4 offered no coverage; 1 state (Oregon) switched from offering moderate coverage to offering full coverage. Compared with the states that offered full coverage, receipt of postpartum care among immigrants was 7.0-percentage-points lower (95% CI, -10.6 to -3.4 percentage points) in the states that offered moderate coverage and 11.3-percentage-points lower (95% CI, -13.9 to -8.8 percentage points) in the states that offered no coverage. The differences in the receipt of postpartum care among immigrants relative to nonimmigrants were also associated with the coverage categories. Compared with the states that offered full coverage, there was a 3.3-percentage-point larger difference (95% CI, -5.3 to -1.4 percentage points) in the states that offered moderate coverage and a 7.7-percentage-point larger difference (95% CI, -10.3 to -5.0 percentage points) in the states that offered no coverage. Compared with states without insurance restrictions, immigrants living in states with public insurance restrictions were less likely to receive postpartum care. Restricting public insurance coverage may be an important policy-driven barrier to receipt of recommended pregnancy care and improved maternal health among immigrants.
The distinction between long-term knowledge and short-term control processes is valid and useful
Authors: Richard M Shiffrin, Walter Schneider, Gordon D Logan
Journal: Behavioral and Brain Sciences (2023)

Abstract The binary distinction De Neys questions has been put forward many times since the beginnings of psychology, in slightly different forms and under different names. It has proved enormously useful and has received detailed empirical support and careful modeling. At heart the distinction is that between knowledge in long-term memory and control processes in short-term memory.
Deliberative control is more than just reactive: Insights from sequential sampling models
Authors: Hyuna Cho, Yi Yang Teoh, William A Cunningham, Cendri A Hutcherson
Journal: Behavioral and Brain Sciences (2023)

Abstract Activating relevant responses is a key function of automatic processes in De Neys's model; however, what determines the order or magnitude of such activation is ambiguous. Focusing on recently developed sequential sampling models of choice, we argue that proactive control shapes response generation but does not cleanly fit into De Neys's automatic-deliberative distinction, highlighting the need for further model development.
Factors influencing surgical performance and learning progress in minimally invasive surgery – results of an interdisciplinary multicenter study
Authors: Johannes Ackermann, Jorun Baumann, Julian Pape, Julia Pahls, Zino Ruchay, Carolin Spüntrup, Bernd Holthaus, Günter Noé, Michael Anapolski, Ivo Meinhold-Heerlein, Göntje Peters, Damaris Willer, Anna Westermann, Sandra Brügge, Veronika Günther, Nicolai Maass, Liselotte Mettler, Ibrahim Alkatout
Journal: International Journal of Surgery (2023)

Advancing surgical techniques require a high level of adaptation and learning skills on the part of surgeons. The authors need selection procedures and decision support systems for the recruitment of medical students and young surgeons. The authors aimed to investigate factors influencing the surgical performance and learning abilities of surgeons and medical students.The training scores of persons attending 16 standardized training courses (at three training centers) of the German Working Group for Gynecological Endoscopy (AGE e.V.) from 2017 to 2020, individual characteristics, and the results of psychomotor tests of three-dimensional imagination and hand-eye coordination were correlated. Similar analyses were performed for medical students in their final clinical year from 2019 to 2020. The training concept was evaluated in a prospective, multicenter, interdisciplinary, multinational setting.In all, 180 of 206 physicians (response rate 87.4%) and 261 medical students (response rate 100%) completed the multistage training concept successfully. Of personal characteristics, the strongest correlation was noted for good surgical performance and learning success, and the absolute number of performed laparoscopic surgeries ( r =0.28-0.45, P <0.001/ r =0.1-0.28, P <0.05). A high score on the spatial visualization ability test was also correlated with good surgical performance ( r =0.18-0.27, P <0.01). Among medical students with no surgical experience, however, age was negatively correlated with surgical performance, that is the higher the age, the lower the surgical performance ( r =0.13/ r =0.22, P <0.05/ P <0.001).Individual factors (e.g. surgical experience, self-assessment, spatial visualization ability, eye-hand coordination, age) influence surgical performance and learning. Further research will be needed to create better decision support systems and selection procedures for prospective physicians. The possibilities of surgical training should be improved, promoted, and made accessible to a maximum number of surgical trainees because individual learning curves can be overcome even by less talented surgeons. Training options should be institutionalized for those attending medical school.
Deliberation is (probably) triggered and sustained by multiple mechanisms
Authors: Gordon Pennycook
Journal: Behavioral and Brain Sciences (2023)

Abstract De Neys proposes that deliberation is triggered and sustained by uncertainty. I argue that there are cases where deliberation occurs with low uncertainty – such as when problems are excessively complicated and the reasoner decides against engaging in deliberation – and that there are likely multiple factors that lead to (or undermine) deliberation. Nonetheless, De Neys is correct to surface these issues.
A tale of two histories: Dual-system architectures in modular perspective
Authors: John Zerilli
Journal: Behavioral and Brain Sciences (2023)

I draw parallels and contrasts between dual-system and modular approaches to cognition, the latter standing to inherit the same problems De Neys identifies regarding the former. Despite these two literatures rarely coming into contact, I provide one example of how he might gain theoretical leverage on the details of his "non-exclusivity" claim by paying closer attention to the modularity debate.